Long-term outcomes after total pancreatectomy: Special reference to survivors' living conditions and quality of life

Yusuke Watanabe, Takao Ohtsuka, Taketo Matsunaga, Hideyo Kimura, Koji Tamura, Noboru Ideno, Teppei Aso, Yoshihiro Miyasaka, Junji Ueda, Shunichi Takahata, Hisato Igarashi, Toyoshi Inoguchi, Tetsuhide Ito, Masao Tanaka

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Although recent studies have confirmed the safety of total pancreatectomy (TP), appropriate selection of patients for TP has not been well documented. Because patients require lifelong medical treatment and self-management of pancreatic insufficiency after TP, indications for TP should be determined carefully according not only to disease factors but also to the social background of patients. We aimed to clarify long-term outcomes after TP, including the living conditions and quality of life (QoL), of surviving patients. Methods: Medical records of 44 consecutive patients who underwent TP between 1990 and 2013 were reviewed retrospectively; 25 survivors completed cross-sectional clinical surveys and responded to a questionnaire about QoL using Short Form 36v2. Results: Prevalence of morbidity and mortality after TP was 32 and 5 %, respectively. Postoperative complications occurred more frequently in elderly patients than in young patients (48 vs. 14 %; P = 0.02); however, there was no significant difference in mortality, postoperative hospital stay, or survival. Twenty-four of 25 survivors (96 %) could manage pancreatogenic diabetes by themselves, and the median level of glycosylated hemoglobin was 7.4 %. Although one-third of patients after TP complained of diarrhea and the QoL scores of patients with diarrhea were lower than those of patients without diarrhea, QoL scores after TP were virtually comparable with those of the national population, even in elderly patients. Conclusions: TP can be performed safely, even in elderly patients. QoL after TP seems to be acceptable if patients are capable of self-management.

Original languageEnglish
Pages (from-to)1231-1239
Number of pages9
JournalWorld journal of surgery
Volume39
Issue number5
DOIs
Publication statusPublished - May 1 2015

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Pancreatectomy
Social Conditions
Survivors
Quality of Life
Diarrhea
Self Care
Exocrine Pancreatic Insufficiency
Mortality
Glycosylated Hemoglobin A
Patient Selection
Medical Records
Length of Stay
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Surgery

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Long-term outcomes after total pancreatectomy : Special reference to survivors' living conditions and quality of life. / Watanabe, Yusuke; Ohtsuka, Takao; Matsunaga, Taketo; Kimura, Hideyo; Tamura, Koji; Ideno, Noboru; Aso, Teppei; Miyasaka, Yoshihiro; Ueda, Junji; Takahata, Shunichi; Igarashi, Hisato; Inoguchi, Toyoshi; Ito, Tetsuhide; Tanaka, Masao.

In: World journal of surgery, Vol. 39, No. 5, 01.05.2015, p. 1231-1239.

Research output: Contribution to journalArticle

Watanabe, Y, Ohtsuka, T, Matsunaga, T, Kimura, H, Tamura, K, Ideno, N, Aso, T, Miyasaka, Y, Ueda, J, Takahata, S, Igarashi, H, Inoguchi, T, Ito, T & Tanaka, M 2015, 'Long-term outcomes after total pancreatectomy: Special reference to survivors' living conditions and quality of life', World journal of surgery, vol. 39, no. 5, pp. 1231-1239. https://doi.org/10.1007/s00268-015-2948-1
Watanabe, Yusuke ; Ohtsuka, Takao ; Matsunaga, Taketo ; Kimura, Hideyo ; Tamura, Koji ; Ideno, Noboru ; Aso, Teppei ; Miyasaka, Yoshihiro ; Ueda, Junji ; Takahata, Shunichi ; Igarashi, Hisato ; Inoguchi, Toyoshi ; Ito, Tetsuhide ; Tanaka, Masao. / Long-term outcomes after total pancreatectomy : Special reference to survivors' living conditions and quality of life. In: World journal of surgery. 2015 ; Vol. 39, No. 5. pp. 1231-1239.
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AU - Watanabe, Yusuke

AU - Ohtsuka, Takao

AU - Matsunaga, Taketo

AU - Kimura, Hideyo

AU - Tamura, Koji

AU - Ideno, Noboru

AU - Aso, Teppei

AU - Miyasaka, Yoshihiro

AU - Ueda, Junji

AU - Takahata, Shunichi

AU - Igarashi, Hisato

AU - Inoguchi, Toyoshi

AU - Ito, Tetsuhide

AU - Tanaka, Masao

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Although recent studies have confirmed the safety of total pancreatectomy (TP), appropriate selection of patients for TP has not been well documented. Because patients require lifelong medical treatment and self-management of pancreatic insufficiency after TP, indications for TP should be determined carefully according not only to disease factors but also to the social background of patients. We aimed to clarify long-term outcomes after TP, including the living conditions and quality of life (QoL), of surviving patients. Methods: Medical records of 44 consecutive patients who underwent TP between 1990 and 2013 were reviewed retrospectively; 25 survivors completed cross-sectional clinical surveys and responded to a questionnaire about QoL using Short Form 36v2. Results: Prevalence of morbidity and mortality after TP was 32 and 5 %, respectively. Postoperative complications occurred more frequently in elderly patients than in young patients (48 vs. 14 %; P = 0.02); however, there was no significant difference in mortality, postoperative hospital stay, or survival. Twenty-four of 25 survivors (96 %) could manage pancreatogenic diabetes by themselves, and the median level of glycosylated hemoglobin was 7.4 %. Although one-third of patients after TP complained of diarrhea and the QoL scores of patients with diarrhea were lower than those of patients without diarrhea, QoL scores after TP were virtually comparable with those of the national population, even in elderly patients. Conclusions: TP can be performed safely, even in elderly patients. QoL after TP seems to be acceptable if patients are capable of self-management.

AB - Background: Although recent studies have confirmed the safety of total pancreatectomy (TP), appropriate selection of patients for TP has not been well documented. Because patients require lifelong medical treatment and self-management of pancreatic insufficiency after TP, indications for TP should be determined carefully according not only to disease factors but also to the social background of patients. We aimed to clarify long-term outcomes after TP, including the living conditions and quality of life (QoL), of surviving patients. Methods: Medical records of 44 consecutive patients who underwent TP between 1990 and 2013 were reviewed retrospectively; 25 survivors completed cross-sectional clinical surveys and responded to a questionnaire about QoL using Short Form 36v2. Results: Prevalence of morbidity and mortality after TP was 32 and 5 %, respectively. Postoperative complications occurred more frequently in elderly patients than in young patients (48 vs. 14 %; P = 0.02); however, there was no significant difference in mortality, postoperative hospital stay, or survival. Twenty-four of 25 survivors (96 %) could manage pancreatogenic diabetes by themselves, and the median level of glycosylated hemoglobin was 7.4 %. Although one-third of patients after TP complained of diarrhea and the QoL scores of patients with diarrhea were lower than those of patients without diarrhea, QoL scores after TP were virtually comparable with those of the national population, even in elderly patients. Conclusions: TP can be performed safely, even in elderly patients. QoL after TP seems to be acceptable if patients are capable of self-management.

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